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. 2021 Aug 13;18(16):8581.
doi: 10.3390/ijerph18168581.

Reducing Decision to Incision Time Interval for Emergency Cesarean Sections: 24 Months' Experience from Rural Sierra Leone

Lahai Tucker  1 , Anna Frühauf  1 , Isata Dumbuya  1 , Paul Muwanguzi  1 , Marta Lado  1 , Daniel Lavallie  2 , Mohamed Sheku  3 , Chiyembekezo Kachimanga  1   4
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Reducing Decision to Incision Time Interval for Emergency Cesarean Sections: 24 Months' Experience from Rural Sierra Leone

Lahai Tucker et al. Int J Environ Res Public Health. .

Abstract

Background: This study aimed at describing the changes in the completeness of documentation and changes in decision to incision time interval of emergency cesarean sections after an audit and feedback project a rural hospital in Sierra Leone.

Methods: We documented and monitored the decision and incision times for emergency cesarean sections over the course of two years. Year one focused on the introduction of the project and year two focused on the continuous monitoring of the project. We compared the completeness of decision to incision data and used the 30-min benchmark as target for the decision to incision time interval.

Results: A total of 762 emergency cesarean sections were included. While the completion of decision time data (72%) did not change between the two reporting periods, documentation of incision time increased from 95% to 98% (p < 0.001). Complete documentation for both decision and incision time was available for 540 (70.9%) emergency cesarean sections. The decision to incision time interval decreased from 105 min to 42 min (p < 0.001). The proportion of cesarean sections started within 30 min increased from 8.5% to 37% (p < 0.001).

Conclusion: Although not all cesarean sections were performed within the 30-min threshold, the decision to incision interval decreased significantly. Improvements in documentation and routine reporting of the decision to incision time interval is recommended.

Keywords: Sierra Leone; audit and feedback; cesarean delivery; decision to incision time interval; quality of obstetric care.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Cesarean sections at Koidu Government Hospital between October 2016 and September 2018.
See this image and copyright information in PMC

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